[Surgical treatment for Rathke cleft cysts].

Surgical treatment for Rathke cleft cysts--Intrasellar and suprasellar cysts are often lesions observed in the neuroradiological examinations. The majority of them (craniopharyngioma, cystic pituitary adenoma) are histologically neoplasmic. The others originate from the remnants of the embryonic diverticulum which arise from the roof of the stomodeum. Rathke cleft cyst is the most common cystic developmental lesion of the pituitary gland. It is located within the sella turcica as well as over the diaphragm, near the stalk. Occasionally, they may become large enough to cause typical symptoms and signs headaches, adenohypophysis disfunction, diabetes insipidus and visual field defects. Asymptomatic Rathke cleft cyst should be observed (detailed endocrinological and radiological examination of the pituitary gland). Magnetic resonance imaging (MRI) is the preferred neurodiagnostic study in evaluating the Rathke cleft cyst. Aspiration of cyst contents and cyst wall biopsy or it's total removal are the operative treatment of the symptomatic cysts. Transsphenoidal approach is usually effective. Reccurence of Rathke cleft cyst after surgical treatment is rare. The authors present 16 cases of Rathke cleft cysts operated on during the period from January 1996 to December 2002. We observed 12 intrasellar cysts and 4 suprasellar lesions. Fourteen patients underwent transsphenoidal procedure and four patients were operated on via transcranial route. Histological examination confirmed Rathke cleft cyst. There were no serious complications in our group. Follow-up examination comprises periodic endocrinological and radiological investigations.